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Clinical Quality Management Assistant

4 months ago


Staten Island, United States Centers Choice Home Care Full time

Title: Quality Management Assistant

Responsible to: Director Quality Management

**Duties**:
1. Provides general clerical assistance to the QM Director/Compliance Officer and the QM Clinical Analyst such as faxing, copying, scanning and file maintenance.

2. Medical Record Requests: receives and logs requests, obtains necessary authorizations for release of PHI, prints record for QM clinical review. Works collaboratively with Accounts Receivable to prepare invoices and ensures fees are collected and records are released after receipt of payment.

3. Receives Medicare Notices of Non-coverage and Patient Acknowledgement forms from field staff and processes related workflow in HCHB. Reviews forms for proper completion and provides feedback to clinician regarding errors or omissions.

4. Conducts compliance related auditing under as assigned by the QM Director/Compliance Officer. Auditing includes but is not limited to patient signature audits, visit time auditing, HHA vendor exception auditing.

5. Assists the QM Director/Compliance Officer with vendor related activities including but not limited to obtaining insurance certificates, wage parity certifications and yearly update of vendor personnel contact lists. Maintains spread sheets accordingly.

6. Assists QM with Medicare Expedited appeals: logs request, obtains necessary documents from staff, forwards to the QIO, prints chart and sends chart to QIO if requested. Tracks status and response to appeal.

7. Assists QM Director with tracking and correspondence on lawsuits.

8. Utilization Review: Identifies charts for review under guidance of QM Clinical Analyst. Assigns charts to reviewers. Ensures all paper documents are available for review. Assists QM Dept. to ensure reviews are completed in the time frame allotted and gives reports to Director/Manager.

9. Incident reporting: assists QM with logging and tracking receipt of written incident report from the clinical staff. Work with QM to ensure reports are reviewed and complete.

10. Assists QM Director/Compliance Officer with Professional Advisory Committee and UR preparation including meeting set up, invitations, PowerPoint’s and handouts and minutes. Also assists with Compliance Committee preparation in the same manner.

11. Other related duties in the Quality Management/Compliance Department

Experience: At least 2 years’ experience in an administrative assistant’s role, previous work in quality management desirable.

Education: high school graduate, college degree preferred.

Technical Skills: Word, Excel, PowerPoint

Pay: $45,000.00 - $55,000.00 per year

**Benefits**:

- 401(k)
- 401(k) matching
- Dental insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance

Schedule:

- Monday to Friday

Work setting:

- In-person

Application Question(s):

- Do you have experience in Healthcare / Medical / Clinical or Related Industry?

Ability to Relocate:

- Staten Island, NY 10304: Relocate before starting work (required)

Work Location: In person